Schizophrenia is second only to age when it comes to risk factors for dying from COVID-19, new research suggests.
People with this mental illness are known to be at greater risk for contracting COVID-19, but the new study shows they are also more likely to die from this virus.
"Old age is still the most important risk factor for dying of COVID-19, but in our study, schizophrenia surpassed even heart, lung and kidney disease," said study author Dr. Donald Goff, director of the Institute for Psychiatric Research at NYU Langone in New York City.
"We believe that people with schizophrenia should be prioritized in terms of receiving COVID 19 vaccinations and encouraged to observe safety precautions," said Goff, who is also a psychiatry professor at NYU Langone.
Symptoms of schizophrenia include hallucinations, delusions and disorganized thinking. The illness often first appears in the late teens to early 30s, and people with schizophrenia are known to die earlier than people without it, according to the U.S. National Institute of Mental Health.
In the study, people with schizophrenia were nearly three times more likely to die from COVID-19, compared to individuals without the illness, and this held even after researchers took other factors that affect risk of dying from COVID into account.
"The higher risk was expected, but the magnitude was unexpected," Goff said.
And the increased chance of dying is not tied to risks known to travel with mental illness such as higher rates of heart disease, diabetes and smoking.
"There may be immune deficits associated with the illness that could be related to genetics," Goff said.
Alternatively, some of the medications that treat schizophrenia cause weight gain and increased risk for diabetes and could play a role, he explained. The next step is to investigate whether these drugs affect chances of dying from COVID-19, he said.
Goff and colleagues reviewed medical records from almost 7,350 men and women treated for COVID-19 in New York last March, April and May. Of these, 14% were diagnosed with schizophrenia, mood disorders or anxiety, but only those with schizophrenia were more likely to die from COVID once infected.
"It's reassuring that people with other mental health problems such as mood or anxiety disorders were not at increased risk of death from coronavirus infection," Goff said.
The study was published Jan. 27 in JAMA Psychiatry.
People with schizophrenia and their caregivers need to double down on efforts to prevent COVID-19, including wearing masks and practicing social distancing, said Dr. Jeffrey Borenstein, president and CEO of the Brain and Behavior Research Foundation in New York City. He was not part of the new study.
"They need to follow all of the safety precautions to reduce chances of becoming infected, and as soon as a person is able to, they should take the vaccine, which offers significant protection with regards to COVID-19," Borenstein said.
It's also important to manage the symptoms of schizophrenia with medication and self-care, he said.
Living through a pandemic and all of the fear and restrictions it adds to daily life is stressful, and stress is known to make symptoms of mental illness, including schizophrenia, worse, Borenstein noted.
Staying connected can help buffer stress. "You can be careful and still keep in touch with others by phone, Zoom, FaceTime or in a safe way outdoors as long as you are socially distant and wearing a mask," he said.
Taking walks outside is also safe and counts as exercise. Exercise is known to improve physical and mental health for people with schizophrenia, Borenstein added.
The Brain and Behavior Research Foundation has more about schizophrenia and its treatments.
SOURCES: Donald Goff, MD, Marvin Stern Professor of Psychiatry, NYU Langone, and director, Nathan S. Kline Institute for Psychiatric Research, NYU Langone, New York City; Jeffrey Borenstein, MD, president and CEO, Brain and Behavior Research Foundation, New York City; JAMA Psychiatry, Jan. 27, 2021